Locate Us:
2nd Floor, Akerman Health Centre
60 Patmos Road, London, SW9 6AF
Tel. 020 3049 6500
Fax. 020 3049 6515
Navigation Menu
Close Menu
Home
Services
Compliments & Suggestions
GDPR & PRIVACY NOTICE
GDPR Patient Leaflet PRIVACY NOTICE
Close Menu

Acne Treatment Online Consultation

Please fill out the form below, and one of our doctors will contact you regarding the consultation:

Patient Information

Name: *
Date Of Birth: *
NHS Number (if known):
Address:
Postcode:
Contact Number: *
E-Mail Address: *

Consultation Information

1. Have you read information about your symptoms on Patient.info?

    It is advised that you read up about this condition and the related symptoms.

    Yes

    No

    2. Have you seen a doctor face-to-face and been diagnosed with acne?

      You must see a doctor for a diagnosis before using online treatment. We are unable to supply acne treatment for you.

      Yes

      No

      3. Are you aware you should NOT USE more than one of the SAME TYPE of topical treatments at the SAME TIME?

      • Zineryt and Dalacin T - Both Antibiotics
      • Differin and Istorex - Both Retinoids
      • Epiduo - Antibiotic with Retinoid
      • Duac - Antibiotic with peeling agent (benzoyl peroxide)
      You should NOT USE more than one of the SAME TYPE of topical treatments at the SAME TIME? You can change your answer and continue.

      Yes

      No

      4. Are you aware Lymecycline antibiotic tablets should not be taken whilst using Zineryt, Dalacin T and Duac (topical antibiotics)?

      • Lymecycline can be taken whilst using Differin Istorex and Epiduo.
      Lymecycline antibiotic tablets should not be taken whilst using Zineryt, Dalacin T and Duac (topical antibiotics). You can change your answer and continue.

      Yes

      No

      5. Are you aware it usually takes 8 weeks or more of continuous usage for treatments to work?

      • If there is no improvement after 4 months, treatment should be stopped or changed
      It often takes 8 weeks or more for treatment to work. You can change your answer and continue.

      Yes

      No

      6. Are you aware, if acne has cleared-up, treatment can sometimes be stopped or reduced after 4 to 6 months?

        Acne treatment can sometimes be stopped or reduced after 4 to 6 months, if acne has cleared up. You can change your answer and continue.

        Yes

        No

        7. Are you aware you should see your GP if acne is scarring or getting worse?

          You should see your GP if acne is scarring or getting worse. You can change your answer and continue.

          Yes

          No

          8. Are you allergic to the treatment you plan to order?

          • Zineryt (erythomycin), Dalacin T (clindamycin), Differin (adapalene), Isotrex (isotretinoin), Epiduo (adapalene with benzoyl peroxide), Duac (adapalene with clindamycin), Lymecycline (tetracycline).
          We are unable to supply you with treatment. Please see your GP.

          Yes

          No

          9. Are you aware the following treatments should NOT be used if you are pregnant or breast feeding?

          • Differin
          • Isotrex
          • Epiduo
          • Duac
          • Lymecycline
          Differin, Isotrex, Epiduo, Duac, Lymecycline should NOT we used or taken whilst pregnant or breast feeding. You can change your answer and continue.

          Yes

          No

          10. Are you currently using oral contraception?

            Yes

            No

            11. Are you aware topical treatments containing retinoids and peeling agents (Differin, Isotrex, Epiduo and Duac) can be irritant?

            • Irritation can be reduced by starting treatment on alternate days, and building up to the prescribed dose as tolerated.
            Topical treatments containing retinoids and peeling agents (Differin, Isotrex, Epiduo and Duac) can be irritant. Irritation can be reduced by starting treatment on alternate days, and building up to the prescribed dose as tolerated. You can change your answer and continue.

            Yes

            No

            12. Are you ordering Lymecycline and been diagnosed with liver or kidney disease?

              We are unable to supply you with treatment. Please see your GP.

              Yes

              No

              13. Do all of the following apply to you?

              • I will read the patient information leaflet supplied with my medication.
              • The medication is for my own use. (Partners, spouses etc must log out, complete their own consultation and register separately)
              The conditions must apply for you to be able to use this service.

              Yes

              No